Knotless instability suture anchor construct and system
An anchor construct having an anchor having a length of suture material passing therethrough, the suture material having a loop strand terminating at a first end and a post strand terminating at a second end, a splice loop formed by first end, a sliding construct formed by the first end and the second end, wherein the sliding construct is configured to adjust the relative position of the splice loop and the anchor. The anchor construct can be deployed by passing the first end through a first body and through the splice, creating a locking loop of a first size around the first body, implanting the anchor into a bone hole, pulling the post strand to decrease the perimeter of the positioning loop to a second size smaller than the first size, and pulling the loop strand to decrease the perimeter of the locking loop to a smaller second size.
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The present application relates and claims priority to U.S. Provisional Application No. 62/518,344 filed Jun. 12, 2017, the entirety of which is hereby incorporated by reference
BACKGROUND OF THE INVENTION Field of the InventionThe present invention is related to a suture anchor device for soft tissue to bone repair in surgical procedures and, more particularly, to a knotless suture anchor with a sliding construct for tissue tensioning and a splice to secure the tissue in relative position to the bone.
Description of the Related ArtSuture anchors are commonly used to repair soft tissue to bone in surgical procedures, such as shoulder instability repair. Typically, the suture anchors are inserted into a pre-formed bone hole and then the sutures are passed through the tissue to be repaired. In many cases, a sliding knot is tied, which provides better tissue tensioning control and allows the surgeon to manipulate the sliding knot in order to bring the tissue into apposition to the bone. In doing so, the tissue is naturally brought back to the point of origin of the suture and comes to rest directly over the bone hole. To secure the sliding knot, the surgeon ties one or more alternating half-hitch knots to complete the procedure. The act of tying a knot presents a number of challenges to the surgeon, especially when doing so arthroscopically. Furthermore, in some cases, knots have been implicated as the source of post-operative pain caused by irritation from the knot stack.
Various types of suture anchors have been developed which fasten the suture in place without requiring the surgeon to tie a knot, as should be understood by those of skill in the art. Some designs capture the suture between two anchor components, while others utilize an interference fit between the anchor and the bone tunnel. Many designs using these methods of fixation require a driver to be engaged with the anchor while tensioning the suture in order to bring the tissue into apposition to the bone. Since the driver is still engaged in the bone hole when in use, it can prohibit tensioning of the tissue so that it is directly over the bone hole (suture origin) thus giving a less than ideal tissue position and encumbering the adjustment of suture tension.
Attempts at addressing the problem of tissue position include implementation of an adjustable loop which is formed around the tissue to be repaired. In this instance, the anchor is installed in the bone hole and then the driver is removed. One limb of the suture is free and is passed first through the tissue and then into a loading filament which passes it back through the suture limb to create a one-way loop. However, this requires the standing end of the suture to remain fixed so that it acts as a ‘finger trap’ when the loop is tensioned thereby preventing loop loosening. This method also requires a long length of suture to pass through or around the tissue before the loop is reduced which can cause damage by abrasion. Furthermore, the fixed end must reside deep in the hole and must not migrate or tensioning; will be limited. Lastly, this type of conventional device is comprised of a rigid material which can damage tissue if it is pulled out of the bone hole during healing.
Therefore, the inventors recognized that a need exists for a simple-to-use suture anchor comprised of soft materials which secures suture without the need to tie a knot, and which facilitates the ability to adjust, maintain, and position tissue in a desired location over the bone hole during anchor installation.
Description of the Related Art Section Disclaimer: To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section or elsewhere in this disclosure, these discussions should not be taken as an admission that the discussed patents/publications/products are prior art for patent law purposes. For example, some or all of the discussed patents/publications/products may not be sufficiently early in time, may not reflect subject matter developed early enough in time and/or may not be sufficiently enabling so as to amount to prior art for patent law purposes. To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section and/or throughout the application, the descriptions/disclosures of which are all hereby incorporated by reference into this document in their respective entirety(ies).
BRIEF SUMMARY OF THE INVENTIONEmbodiments of the present invention recognize that there are potential problems and/or disadvantages with the conventional knot or knotless suture constructs. For example, knots and knotless constructs can be large and rigid enough to cause irritation, and require constant engagement by the driver during installation which results in less than ideal positioning of the tissue over the bone hole (as described above). Therefore, a need exists for a simple-to-use soft locking suture construct with a means for adjusting, maintaining and positioning tissue in a desired location over the bone hole during anchor installation. Various embodiments of the present invention may be advantageous in that they may solve or reduce one or more of the potential problems and/or disadvantages discussed herein.
The present disclosure is directed to an inventive configuration, structure, and resulting function of a knotless instability suture anchor construct and system. The knotless instability suture anchor construct includes an anchor with passing suture material having a first end and a second end, a splice loop at the first end, and a sliding construct (e.g. a knot) created by the first end and the second end. The sliding construct is configured to adjust the relative position of the splice loop and the anchor.
According to another aspect, a knotless instability suture anchor system is provided that includes a threader assembly having a cover and a back piece with a removable threader arm. The removable threader arm has a circular raised hook configured to maintain threader material in a threader loop. The cover has a pair of movable clips configured to lock into clip receiving apertures on a back piece. A channel extends through the threader assembly along both the back piece and the cover. The system also includes a knotless instability suture anchor construct having an anchor with passing suture material. The passing suture material has a first end and a second end, a splice at the first end, and a sliding construct created by the first end and the second end. The sliding construct adjusts the relative position of the splice and the anchor. The knotless instability anchor construct extends along the channel in the threader assembly, and a threader loop is secured around the hook of the threader arm. The ends of the threader loop extend through the splice and outside the threader assembly.
According to an another aspect, a method of securing a first body in relative position to a bone hole includes (but is not limited to) the steps of: (i) providing a knotless instability suture anchor construct having an anchor with passing suture material including a first end and a second end, a splice positioned in the first end, a sliding construct created by the first end and the second end, wherein the sliding construct creates a positioning loop in the suture material of a first size with a perimeter defined at least in part by the anchor; (ii) passing the first end through a first body and through the splice; (iii) creating a locking loop of a first size around the first body; (iv) implanting the anchor into a bone hole; (v) pulling the post strand to decrease the perimeter of the positioning loop to a second size smaller than the first size; and (vi) pulling the loop strand to decrease the perimeter of the locking loop to a second size smaller than the first size.
Suture material or sutures, as the terms are used and described herein, include monofilament or multi-filament suture as well as any other metallic or non-metallic filamentary or wire-like material suitable for performing the function of a suture. This material can include both bioabsorbable and non-absorbable materials.
The present invention will be more fully understood and appreciated by reading the following Detailed Description in conjunction with the accompanying drawings. The accompanying drawings illustrate only typical embodiments of the disclosed subject matter and are therefore not to be considered limiting of its scope, for the disclosed subject matter may admit to other equally effective embodiments.
Reference is now made briefly to the accompanying drawings, in which:
Referring now to the drawings, wherein like reference numerals refer to like parts throughout, there is seen in
In the depicted embodiment, the length of suture 12 is woven through the anchor 14 such that the length of suture 12 enters and exits the anchor 14 at six apertures 16 along the anchor 14. Weaving the length of suture 12 through the anchor 14 at six apertures 16 is especially beneficial (although any number of apertures can be used as may be appropriate to meet the desired functionality of the suture construct 10) when the anchor 14 is an all-suture anchor because there is sufficient tension to deploy and expand the anchor 14 without risking the length of suture 12 pulling through the space between numerous apertures 16 in close proximity. Other configurations and similar suture anchors can be applied to the construct 10 while remaining within the spirit and scope of embodiments of the present invention.
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To create a one-way splice or locking loop 40 in the splice 30, the first end 22 is passed through the aperture 34 of the splice 30 in a clockwise fashion, as shown in
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Thereafter, the driver 300 pushes the anchor 14 into the bone hole 518, as shown in
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While embodiments of the present invention has been particularly shown and described with reference to certain exemplary embodiments, it will be understood by one skilled in the art that various changes in detail may be effected therein without departing from the spirit and scope of the invention as defined by claims that can be supported by the written description and drawings. Further, where exemplary embodiments are described with reference to a certain number of elements it will be understood that the exemplary embodiments can be practiced utilizing either less than or more than the certain number of elements.
Claims
1. A knotless instability suture anchor construct, comprising:
- an anchor having a length of suture material passing therethrough, the suture material having a loop strand having a central longitudinal axis extending along the length thereof from a first end to a second end thereof and terminating at the first end and a post strand terminating at the second end;
- a splice loop formed by the first end, wherein the splice loop is formed by a length of the loop strand extending into an interior of the loop strand through a first aperture, the length of the loop strand extending parallel to and coaxially along the central longitudinal axis and along the length of the loop strand while within the interior of the loop strand, and extending back outside of the interior of the loop strand through a second aperture, wherein the first and second aperture are on the same side of the loop strand;
- a sliding construct formed by the first end and the second end;
- wherein the sliding construct is configured to adjust the relative position of the splice loop and the anchor.
2. The suture construct of claim 1, further comprising a fixed gap between the splice loop and the sliding construct.
3. The suture construct of claim 1, wherein the sliding construct is positioned distally to the splice loop.
4. The suture construct of claim 1, wherein the sliding construct is selected from the group consisting of a single friction hitch and a multiple friction hitch.
5. The suture construct of claim 1, wherein the loop strand is configured to be pulled to decrease the perimeter of the splice loop from a first size to a second size smaller than the first size.
6. The suture construct of claim 1, wherein the anchor is selected from the group consisting of an all-suture anchor and a rigid anchor.
7. The suture construct of claim 1, wherein the sliding construct creates a positioning loop in the suture material of a first size defined at least in part by the anchor, wherein the post strand is configured to be pulled to decrease the perimeter of the positioning loop to a second size smaller than the first size.
8. The suture construct of claim 1, wherein the suture material passes through the anchor at six locations.
9. A knotless instability suture anchor system, comprising:
- a threader assembly comprising a cover and a back piece with a removably attached threader arm, the cover having at least one movable clip configured to lock into a clip receiving aperture on the back piece;
- a channel extending through the threader assembly in both the back piece and the cover;
- a hook on the removable threader arm;
- a knotless instability suture anchor construct comprising an anchor having a length of suture material passing therethrough, the suture material having a loop strand terminating at a first end and a post strand terminating at a second end, a splice formed through the first end, a sliding construct formed by the first end and the second end, wherein the sliding construct is configured to adjust the relative position of the splice and the anchor;
- wherein the knotless instability anchor construct extends along the channel; and
- a threader loop secured around the hook with ends which extend through the splice and outside the threader assembly.
10. The system of claim 9, further comprising a fixed gap between the splice and the sliding construct.
11. The system of claim 9, wherein the sliding construct is positioned distally to the splice.
12. The system of claim 9, wherein the sliding construct comprises a friction hitch.
13. The system of claim 9, further comprising a driver extending through the channel with the anchor loaded thereon.
14. A method of securing a first body in relative position to a bone hole, the method comprising the steps of:
- providing a knotless instability suture anchor construct comprising an anchor having a length of suture material passing therethrough having a loop strand terminating at a first end and a post strand terminating at a second end, a splice formed in the first end, a sliding construct formed by the first end and the second end, wherein the sliding construct creates a positioning loop in the suture material of a first size defined at least in part by I259 and (splice or apperature).clm.the anchor;
- passing the first end through the first body and through the splice, creating a locking loop of a first size around the first body;
- implanting the anchor into the bone hole;
- pulling the post strand to decrease the perimeter of the positioning loop to a second size smaller than the first size;
- pulling the loop strand to decrease the perimeter of the locking loop to a second size smaller than the first size; and
- wherein the step of passing the first end through the first body and through the splice, creating the locking loop of the first size around the first body includes the steps of: inserting a threader loop through the splice through a first aperture toward the first body; passing the first end through the threader loop; and pulling the threader loop through the splice and out of a second aperture, wherein the first and second apertures are on the same side of the splice.
15. The method of claim 14, further comprising the step of excising a portion of the first end and the second end.
16. The method of claim 14, wherein the step of pulling the post strand to decrease the perimeter of the positioning loop to the second size smaller than the first size moves the locking loop toward the positioning loop.
17. The method of claim 14, further comprising the step of loading the positioning loop onto a driver.
18. The method of claim 14, wherein the knotless instability suture anchor construct comprises a fixed gap between the splice and the sliding construct.
19. The method of claim 14, wherein the first body is a tissue.
20130190819 | July 25, 2013 | Norton |
20130296934 | November 7, 2013 | Sengun |
20140277133 | September 18, 2014 | Foerster |
20150351739 | December 10, 2015 | Napolitano |
Type: Grant
Filed: Jun 7, 2018
Date of Patent: Jan 31, 2023
Patent Publication Number: 20180353167
Assignee: Conmed Corporation (Utica, NY)
Inventors: Giuseppe Lombardo (New Port Richey, FL), Grady Breslich (Bradenton, FL)
Primary Examiner: Kelly J Bekker
Assistant Examiner: Andrew P. Restaino
Application Number: 16/002,189
International Classification: A61B 17/04 (20060101); A61B 17/06 (20060101); A61B 17/17 (20060101); A61B 17/00 (20060101); A61B 17/16 (20060101);